对于ERCP后胰腺炎预防的N-乙半氨酸:系统性审查和元分析
Anshuman Elhence1, Prabhaker Mishra2, Praveer Rai3
1Department of Gastroenterology, Sanjay Gandhi Post-Graduate Institute of Medical Sciences, Lucknow, 226 014, India.
概括
N-乙半氨酸 (NAC) 似乎不能预防ERCP后胰腺炎 (PEP) 或严重的PEP. 这次元分析发现,与安慰剂相比,NAC预防对接受ERCP的患者没有显著的保护作用.
科学领域:
- 胃肠病学 胃肠病学
- 临床试验 临床试验
- 医学研究 医学研究
背景情况:
- 氧化应激与ERCP后胰腺炎 (PEP) 的发展有关.
- 作为自由基清除剂的N-乙半氨酸 (NAC) 已被用于PEP预防.
- 了解NAC的疗效对于预防ERCP相关并发症至关重要.
研究的目的:
- 系统地评估N-乙半氨酸 (NAC) 在预防ERCP后胰腺炎 (PEP) 的有效性.
- 评估NAC在减少严重PEP发病率方面的作用.
- 通过元分析综合现有研究的证据.
主要方法:
- 在MEDLINE,EMBASE和Scopus数据库中进行系统的文献搜索.
- 使用随机效应模型对PEP和严重PEP的相对风险 (RR) 的元分析.
- 使用漏斗图表,埃格尔测试和柯克兰偏差风险工具评估出版偏差和研究质量.
主要成果:
- 包括五项研究,共784名参与者 (388名NAC,396名安慰剂).
- 聚合PEP的RR为0.74 (95%CI0.48-1.15) 具有中等的异质性.
- 严重PEP的聚合RR为0.27 (95%CI0.03-2.43) 没有异质性;没有检测到出版偏差.
结论:
- 与安慰剂相比,N-乙半氨酸 (NAC) 预防没有显著地预防PEP发生.
- 在这次元分析中,NAC没有证明对严重的PEP有显著的预防作用.
- 目前的证据表明,NAC对PEP预防不有效.
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